Brandon Ambulatory Surgery Center LC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

BRANDON AMBULATORY SURGERY CENTER LC

Practice address

514 Eichenfeld Drive
Brandon, FL 33511

Phone

(813) 571-7088

Fax

(813) 571-7099

NPI assigned

Oct 3, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Paula Russo

Title

Chief Administrative Officer

Phone

(813) 571-7088

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• East Hillsborough Surgery Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568678400000",
    "number": "1710071519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 EICHENFELD DRIVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "33511",
            "telephone_number": "813-571-7088",
            "fax_number": "813-571-7099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 EICHENFELD DRIVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "33511",
            "telephone_number": "813-571-7088",
            "fax_number": "813-571-7099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANDON AMBULATORY SURGERY CENTER LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2019-09-17",
        "status": "A",
        "authorized_official_last_name": "RUSSO",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "813-571-7088"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "076908800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Hillsborough Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Felicia Rose Bramwell-Williams, APRN
• Dona Maria Bramwell, ARNP
• Daniel Branca, DMD
• Christopher Brancato
• Brandon Advanced Dental Care PA
• Brandon Anesthesia Associates LLC
• Brandon Area Ear, Nose and Throat, P.a.
• Brandon Area Primary Care, PA
• Brandon Assessment and Counseling Center Inc
• Brandon Assisted Living LLC

• Ambulatory Surgical Clinic/Center in Brandon, FL
• Providers in Brandon, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.